In case you didn’t already know, our very own Austin Love Doctor™, Dr. Emily Porter, hosts a podcast! She uses her extensive experience as a sexual wellness doctor in Austin to discuss important sexual health topics.Check out the transcription of the first episode below. In it, you can learn about sexual health, platelet-rich plasma (PRP), the O-Shot®, the P-Shot®, GAINSWave®, Testosterone, Libido, Bioidentical Hormones, and more, straight from a sexual wellness doctor in Austin.
“I’m Emily Porter, a sexual wellness doctor in Austin, Texas, the Austin Love Doctor. I’m a mother of four children.
I birthed four kids in four years and two months. I became pregnant on my honeymoon and was essentially pregnant for five years until my first kid entered kindergarten.
They were all vaginal deliveries, some with epidurals and some without. One got stuck, then two got stuck, and one had a broken clavicle. It wasn’t all fun, but I love my kids and my husband. I have a great family.
After having kids, I worked as an emergency room physician for 11 or 12 years. Why was I an ER physician? As a kid, I became very ill and almost died. I had an appendectomy that went very badly. Emergency surgery was required. They opened me up and I had a colostomy (a nice way of saying “poop out of your stomach”) at nine years old. That lasted three months, then it was reversed.
I didn’t know I wanted to be a sexual wellness doctor in Austin, or anywhere else for that matter, but I always wanted to be a doctor because the surgeon almost killed me. At nine years old, I knew I could do a better job taking care of people than he ever could. My goal was always to be a doctor. I thought being a reconstructive plastic surgeon would be rewarding. Fixing broken people self-conscious about their appearance from a burn incident, being mauled by a dog, or issues requiring reconstructive surgery. There was a psychological component to it.
I went to medical school with the idea that I would go be a reconstructive plastic surgeon. Not a sexual wellness doctor in Austin. My family joked that I would do their Botox®. I had melanoma in college, and so I toyed around with being a dermatologist for a little while. I always thought I would do something in aesthetics.
I went to medical school, and discovered that I hate surgery. This was upsetting because I had to rethink the plan. Surgery is fascinating. I volunteered a couple of years ago in Guatemala and helped kids with cleft palates, and it was amazing to be in an operating room and see the surgery.
However, I hate the operating room. You spend 30 minutes scrubbing your arms and hands, put gloves on, and the second you get in there, you need to pee. You’re trying to squeeze back a fart, because it’s so uncomfortable, and you have no idea how long you’ll be there.
What begins as a one-hour long surgery becomes a four-hour long surgery. I was never comfortable in the operating room. That eliminated many specialties including reconstructive plastic surgery. I could have performed boob jobs in a Surgery Center for living, but I didn’t think that would be gratifying enough.
Dermatology was too boring. I thought, “I can’t look at moles all day and think of 10 adjectives for the word ‘brown’ to describe a mole. It’s a brown circle. What more do you need from me?”
I toyed with psychiatry. I thought I liked psychiatry, crazy people, acutely psychotic people in the ER. It was always fun to figure out how those ideas got in their head. It was sad, but it was fun at the same time, because you can’t make that stuff up, but I didn’t enjoy outpatient psychiatry.
I experimented with different things, but hadn’t yet thought of becoming a sexual wellness doctor. I decided I liked enough of everything to do Emergency Medicine for a decade. I worked in New York City, Seattle, and Baltimore in the Trauma Center. I’ve seen it all: busy ERs, rural ERs.
I moved to Austin and worked at an Academic Center and then some community ERs. Did that for 11 years. Then, unfortunately, corporations took over and began telling you how to practice medicine. They told you how long you could spend with a patient. They tracked how long you were in the room with someone. They could tell if you were in the bathroom or eating. I went through all four pregnancies as an ER doctor, with no paid maternity leave. I was there up to 39 weeks, working sometimes 24- and 48-hour shifts.
Patients became difficult and demanding due to online reviews and Google. It’s not their fault. People deserve good care. Paternalism in medicine was a horrible idea. Also, experience matters, and that it’s not Disney World. They tried to turn medicine into purely a patient satisfaction or customer driven business.
If everyone could do it we wouldn’t need doctors, especially sexual wellness doctors, in Austin.We’d just have kiosks, and you could just go, quick, diagnose a sinus infection, and get whatever antibiotic you wanted. It got that way. I just became unhappy around my children, and sort of the way I was being told to work. It wasn’t good anymore. I didn’t feel I was helping people. I felt as if I was giving people drugs that could potentially harm them, such as opioids during the whole opioid crisis, because my job would be threatened if I didn’t.
Or they would say, “I paid a $500 co-pay, and I’m not leaving until I get a Z-Pac,” and I knew that was wrong. I vowed that no matter what I did as a doctor, I would always be ethical, and I would never do a test that wasn’t necessary, even if a patient needed it … Or even if patient wanted it because they wanted it. Anything that could harm. We take this vow, “First, do no harm.” Doing things that could hurt people or that are unnecessary to make a hospital more money or to make a patient happy when it could be harmful to them is bad.
I needed to do something else. After that Guatemala mission trip, I was 35 and I’d never had Botox. I was there, and it was paper charts, and there weren’t all of the clicks. The average ER doctor has 40,000 clicks to get through a shift, which is a lot of clicks. More clicks don’t mean better care. They mean more time away from the patient.
They still used paper charts. Everyone was grateful to have physicians present to help them. I cried at the end, and I’m not a crier. I didn’t cry when any of my kids were born. I cried because it was powerful, and it was exactly being the doctor I wanted to be. I said, “Man, something’s got to change.”
Wives of plastic surgeons look super young because they might’ve been 60 years old, but they’d all had Botox. I toyed with the idea of getting rid of my little angry lines in my mid-30s. I did what no one should do: I bought a Botox treatment performed by an aesthetician from Groupon. I was scared enough to figure out how to do it. I knew she couldn’t screw it up, and I made my friend go first, two weeks before me, so if hers didn’t look bad, I stood a chance.
Botox is amazing. I can see why Allergan [the manufacturer of BOTOX] makes as much money as they do, and why it’s a gateway drug. Three months after getting Botox, I was hooked. I asked, “Can you fix my forehead?” I was shelling out $450 plus tip for Botox.
I thought, “Why am I paying this honey who has no medical education to shoot me up? I can figure out how to do this on my own.” I signed up for a class. That’s probably not what you should do, but like a weekend course, and realized very quickly that a weekend was not anywhere enough time to learn anything. It let me dip my toe in the water and foreshadowed my becoming a sexual wellness doctor in Austin. I took my mom with me to Scottsdale, because my aunt lives there and I needed a model to do a Botox and filler course.
My mom is an entrepreneur and a very good role model. I mean, she was badass, worked very hard, and yet was always there for the important things. She never missed the County Fair. She didn’t miss our birthdays. She traveled when she could. She set a good example and retired well. However, she believes in tough love.
On the plane back, I said, “I’m going to open a medical spa.” She replied, “That’s a fantastic idea.” I thought, “I passed the mom test.” She added, “If you were to tell me you planned to open a clothing boutique, I’d say that’s a horrible idea. The market is not too saturated, and you should do it. We’ve also been waiting our Botox for 12 years, because you didn’t become a plastic surgeon.”
The second time I was pregnant, I got Botox, which you shouldn’t do, and I would never treat a pregnant patient. (Do as I say, not as I do.) Doctors are the worst patients. Between May 1st and September 26th, I found a one room hair salon and financed a $200,000 laser against my income and my husband’s. ER doctor Bessie McCann told me she wished she’d bought a nice laser earlier.
I took classes. I opened a medical spa inside a hair salon when my fourth child was like five-weeks-old. I hired a full-time aesthetician. In Texas, you can delegate procedures to non-medical people like aestheticians and laser techs after you’ve seen the patient. I was able to see new people and do that.
I learned about, and offered, bioidentical hormones. I offered new treatments that weren’t oversaturated, were trendy, and that I believed in. I don’t do anything in my clinic that I don’t believe in. I would never do anything unethical in medicine. I would never offer a treatment that I didn’t think delivered results.
Platelet-rich plasma (PRP) treatments were new, even to sexual wellness doctors: the Vampire Breast Lift®, Vampire Facelift®, O-Shot, Priapus Shot, and BioTE bioidentical hormones. Sciton, my laser company, put me in touch with Dr. Johnny Peet in the Woodlands.
I was going to learn about the O-Shot and the P-Shot from him, because to go down to Alabama to meet Charles Runels, who’s the inventor, it was my schedule for the ER was made and it was, there was a schedule conflict. Johnny taught the procedures, told me to visit, and introduced me to bioidentical hormones. I had a lot of resistance to bioidentical hormones. Physicians are brainwashed that hormones are bad. We’re taught that hormones are bad and cause cancer. “Don’t give her hormones for a minute longer than she needs them.”
There was a big hormone study that used all synthetic hormones. Bad things happened to women and the FDA shut it down. They never teach you the difference between synthetic and bioidentical hormones. There’s a huge difference. I learned how to perform the O-Shot, Priapus Shot, and BioTE.
When I opened my clinic to become a sexual wellness doctor in Austin, I vowed that I would be ethical. I would never do something I didn’t believe in or that didn’t work. I would practice what I preached. I resisted bioidentical hormones. I might have been scared or brainwashed. “They say it’s okay, but I’m not sure. Maybe I don’t need them.”
I learned about them and what testosterone did for libido to women. They’re sometimes used to wean people off antidepressants, optimize the thyroid, and clear the brain fog we all get when we have babies. Mommy brain can go away, because it’s a testosterone deficiency and estrogen imbalance. It doesn’t go away unless you fix it.
I received an O-Shot and started on BioTE. When checking my own levels, I discovered my testosterone was undetectable. I love my husband but didn’t want to have sex with him. He didn’t push it, and we fell into a sexless marriage for a several months.
I asked my friends with good marriages, “How often do you have sex with your husband?” Women ask the same question repeatedly until we get the “normal” answer we want. One friend told me five or six times a week. My response: “You have a hot husband, and you’re hot, and you are not normal.”
I asked until I found people in my situation who struggled to answer, “A few times a month.” Once a week would be on the high end. We all just commiserated with one another, and we all just said, “Oh …” Women try to get the answer we want to normalize things, but we also try to empathize with one another, and that’s great. Try to make each other feel good. I love that about women, but sometimes you need to just say, “No, that’s not normal. You sound like you have a problem.” Seeing a sexual wellness doctor should be on everyone’s list.
My friends said, “Cut yourself some slack. You have four kids at home, you must be busy, and you work very often. Of course you’re tired.” I let myself get brainwashed into thinking that it normal. “Normal” and “common” aren’t the same thing. Common, yes. That’s a problem because we need to have a conversation about this in America. The French are doing it. That’s why they’re all happy. They drink wine and have sex all the time. Women here drink more wine, and that’s only part of the equation.
I tested my testosterone and began testosterone replacement to increase my levels to 200-250. It was marriage saving. I had energy. People ask me, “How do you have so much energy? How do you do it?” I’m a gunner, but a lot of it is due to testosterone.
I’m not doping. I don’t feel high. I’m not taking ADHD meds or anything, but having … Having more sex energizes you too. Sex felt better again. It was great again. Testosterone helps with libido, orgasm, and your thyroid.
I can think clearly, I don’t have brain fog, I have more energy, I’m not tired all the time, and sex is better. I used to joke about “convent mode.” Men want it like many times per hour. It’s like a 20 times an hour, no matter whether they’re getting sex or not, they’re thinking about it all the time.
I stunned to hear Dr. Runels say in one of his recordings, “Anytime…for as Long as You Want” that he masturbated four or five times a day at age 14. “Where? Where are you doing this?” I have two boys at home. Where do they find the time and where are they doing this? Is this at school? I hope I never walk in on that, but I’m sure it’ll happen.
Women don’t think about sex as much. When you don’t have it, a switch in your brain that shuts off the desire. I used to call it “convent mode.” I dated long distance in high school. When I was home with my boyfriend, we had sex and it was good. After I left for boarding school, it took a month or to wear off, it went away and I didn’t miss it anymore. The same thing happened during college and med school.
That happened in my marriage too. I quit having sex and and it wore off. When the sex came back, I was having good sex, I wanted more as a result, was more energized, was able to accomplish more, and slept better.
I added the diVa® vaginal laser device (by Sciton) to my practice as a sexual wellness doctor in Austin. I used it when I was six weeks postpartum and met Dr. Peet. I began treating some patients with that. This was the pivotal moment where I switched my brain from med spa. We did a lot of Botox and fillers and facial laser treatments and CoolSculpting®, and all those sorts of things.
I love all that stuff, and I’ve changed a lot of people’s skin and given a lot of people their confidence back, but I didn’t put a huge emphasis on sexual wellness. I did a lot of women in their 30s on bioidentical hormones. That was probably my biggest, 30s and 40s, and then some perimenopausal women, and an occasional man. Usually, it was a husband of one of my clients. I wasn’t doing tons of O-Shots, tons of Priapus Shots, tons of pure sexual wellness stuff. It definitely wasn’t the majority.
A late 50s aged nurse approached me as a patient. She was already a patient of mine for some of the skin treatments that we offered. But she was interested in finding a sexual wellness doctor in Austin. She’d been getting BioTE, and I’d been treating her for six months. She bought a series of diVa laser treatments, and she bought an O-Shot. I didn’t know a whole lot at the time about her personal life. I knew she was married, but I didn’t know a whole lot more than that.
She came in for her first laser treatment and her O-Shot, and I went to numb her. She’d visited the gynecologist every year, like a good girl. She hadn’t had sex in decade. There were marital issues for the prior three years. It was not comfortable. It was to the point where she didn’t even feel like she could masturbate because it was so uncomfortable. She said, “My clitoris seems like it’s gone.”
I went to put her numbing cream on, and I was hurrying to my next patient, so I like smeared it where I thought it should go. She said, “Good luck finding it. My husband can’t find it, so good luck to you.”
I didn’t think anything of it. I came back, 20 minutes, and so went to do her procedure and did like a proper exam on her, and her clitoris was, like, completely gone. I couldn’t even find it. It wasn’t something I had seen before as a sexual wellness doctor. Thankfully, I had mentors. Her vaginal opening was very small. It was painful to put my index finger in. She’s said, “I don’t know what happened.” She felt bad, as if she wasn’t taking care of herself down there. Even though she’d been seeing a doctor and perhaps felt like something happened because, “If you don’t use it, you lose it,” with her husband, but it was painful.
It was, there was a lot of pain there. Mental pain as well as physical pain. Somehow, we managed to get through her diVa treatment with that, with this dilator, which is not too big, but it wasn’t comfortable for her. It wasn’t fun for me because I knew I was hurting her. I said, “I can’t do your O-Shot because I can’t find your clitoris.”
Afterward, I asked her if it was okay if we snapped some photos with her phone. I showed it to her, because it was hard for her to see, and she wept. I called Dr. Peet and told him what I saw, and he said, “That’s lichen sclerosus.” I knew what that was, but I hadn’t seen it before. That’s, it’s an inflammatory condition that, I’m not sure if it’s autoimmune or what but, basically, it causes this inflammation in women of the genital area.
It can go all the way from the labia minora, the majora, to the vulva area and the vaginal opening, all the way … Anywhere down there. It can go around the anus and perianal areas, and it can itch or it can hurt or it can crack, and it can bleed. There’s not a whole lot to do for it if you don’t see a sexual wellness doctor in Austin. In the past, they gave people steroid creams, but they don’t work and they tell you that you can’t use them for too long because they can thin the tissue.
It’s devastating, because when sex is painful, it’s lonely. Because you have somebody that doesn’t even want to hold their partner’s hand while watching a movie because they don’t want to disappoint them, if the person, if they can’t reciprocate. Or women can fake orgasm, and they can fake interest, and they can fake a lot of things, but it’s hard to fake that you’re not in pain and have somebody not perceive that. But most people don’t think to go to a sexual wellness doctor, even in Austin.
I called Dr. Peet and he said, “That’s lichen, and this is what you should do.” He goes, “Do you still have the PRP?” I said, “No, she’s gone.” He says, “When she comes back, get a biopsy to ensure it’s not vulva cancer. That can look similar.” I didn’t feel comfortable doing that in my office, and she should see a gynecologist. She made an appointment with a gynecologist, and it was two months before she could get in.
In the meantime, we started her on some testosterone cream, estrogen cream, steroid, and I did her diVa. She returned a month later, and we injected platelet rich plasma. I was going to do the O-Shot, but I couldn’t do the clitoral part.
Platelet rich plasma is your blood spun down into growth factors. Think about the yellow goo under a scab when you skin your knee. You know how when you skin your knee and then you get a scab and then a couple, like a week later there’s no scab and now you have skin again, and you can feel nerves there, you didn’t lose your sensation. That’s because it’s basically the same thing. It recruits stem cells in to grow new tissue. I injected all around the area, and we did her diVa.
Two weeks after that second treatment or three weeks after that second treatment, she texted me. Not that many people have my phone number. I’m good with email, but she was one of the people that had it. She said, “I found my clitoris again,” and with like an emoji. I was so happy, and then I cried, because it was powerful to do that as a sexual wellness doctor in Austin. This is something her doctor didn’t even notice or see. I don’t know how they could have missed it.
Anyway, we did our third treatment, and that time I did some laser treatment, externally on that, to try to go through the scar tissue, and injected a whole bunch around. We were able to do her O-Shot. A couple of weeks after the third treatment, she texted me and told me that she’d finally gotten in with her gynecologist, and that there was nothing to biopsy because it had completely gone into remission and the skin had normalized.
A couple of months, she found a lover. She had gone and gotten a tantric massage and found her sensuality back, and was … She came in and she had this necklace on, and took me in a room … This is very Christian woman, and we’re in Texas. We’re in Austin, but we’re still in Texas. She’s like, “Oh, you want to see my new jewelry?” She showed me her necklace and, basically, you could pull this thing out, and it was a vibrator. I’m like, “You get it girl. You get it.” I was so happy for her.
Then she showed me these bracelets. These bracelets are these leather bands, and they had like a little chain that linked them together. She’s said, “They’re handcuffs.” We have a very good patient-doctor relationship. She’s a year and a half out from that treatment, having the best sex of her life. She had recently turned 60, and said, “I could have a stroke or a heart attack tomorrow. I want to enjoy this for as long as I can, because I went so long without it.”
She was one of the main ones that made me say, “This is what I’m meant to do. The rest is great, but someone needs to help these people.” I re-shifted my focus, Sometimes you “fake it ’til you make it.” Perform a few procedures and build a reputation.
It’s hard because people still don’t talk about it. I can tell her story as a sexual wellness doctor in Austin, but I don’t think she shares that story with her family or with her friends, or never, so that’s my story to share. Getting the word out is tough. There are a lot of people who are suffering, and they don’t even want to tell their spouse, even if they’re in a good marriage.
I’ll talk about one more patient. She was the first female, and this other guy was the first male that I felt like I had helped. That was where my focus went.
He was in his early 50s and had done his research. Male patients are always very well researched. They’ve gone to my website. They’ve looked at pictures of my children. They know where I went to college. They know I was magna cum laude from Georgetown, more than the women. The women are more word-of-mouth and the men are more, they’re finding you at night, at 2:00 in the morning when they’re sitting up feeling worthless because they can’t get an erection. Because we can tell where our web traffic comes from, and what time it is. We know exactly what they’re searching for a sexual wellness doctor in Austin, and when they’re searching it.
Their wives don’t often know, like was the case here. He came in and he said, “I’m interested in the Priapus shot,” which is, again, like the orgasm shot and the O-Shot. It’s your own blood, platelet rich plasma that’s spun down and it’s injected. Dr. Runels invented that. Part of it is that you use a pump afterward. Part of it is that you have to put a needle in the penis.
It doesn’t hurt, but you put a needle in somebody, there’s a chance that they might bruise. The pumps, at the time I was using were, they plugged in. I didn’t trust people with the hand vacuum pumps, and they’re vacuum, erectile devices. They help circulate the PRP, and they strengthen the muscles and things. They’re part of the procedure for six weeks.
He said, “I wish I could get this but I can’t, because my wife doesn’t know and I can’t have a bruise, and I can’t use the pump. What else?” I said, “That’s all I can do.” He’d poured all over my website. He asked, “What about that shockwave thing, GAINSWave®?” I’d heard of it. He continued, “You’re a sexual wellness doctor. You already own the machine.” GAINSWave allows you to use various machines, one of which is a Zimmer ZWave, which we already had for CoolSculpting use.
He said, “I want you to do that for me. It doesn’t involve a pump or needles.” I responded, “I don’t know how to do that.” I wasn’t sure that I wanted to spend more money learning how to do something. I thought, “I need a plan for him, because he needs help.” His poor wife didn’t even know he was there.
This happens with men. Their wives don’t know they’re there. They’re not trying to sneak out and be with somebody else. They’re embarrassed and don’t want to tell their wives that they’re coming to a sexual wellness doctor in Austin. She knows something’s not right. We’re not stupid, but many women are paranoid. If you’re not having sex with her, she thinks you’re having sex with your secretary or her sister, so tell your wife.
If you’re in a committed relationship attempting to improve your sexuality, that comes back on your partner. Tell them. It’s the best way things happen. Because if you don’t, and you have guilt and shame, then even if anatomically we get things working, now you have this guilt or this secret or this shame, and then now you can have ED as a, with a psychological component to it. That’s my advice is that you say it to your partner.
He said, “I’ll be your guinea pig.” I was like, “I’ll figure out what I’m doing.” What do you do as a doctor, married to a doctor? You scour the literature. We started looking into articles and found out that they’ve been doing this in Europe for like 30 years. France and the Germans are doing it. They used a machine to send shockwave therapy.
Shockwaves are sound waves that go through the penile tissue, in this case. They clear out plaques that build up with age. Then they also, it stimulates new blood vessel growth and new nerve growth so more blood can flow through. It’s like having a wreck during rush hour and the traffic is slow. It clears the wreck immediately, and then builds a couple of new lanes on the highway, so you end up with more flow, which is what most ED is, it’s a problem of flow.
I thought, “I want to help this guy.” However, I couldn’t, in good conscience, charge him full price. I was winging it. I didn’t know whether he was going to get an outcome. I attended a conference and I asked Michael, with Zimmer, if he knew any of protocols to use as a sexual wellness doctor in Austin looking to get started with the GAINSWave. He gave me ideas.
I tried it at home. Somewhere in one of my treatments, he asked … He was a fluid engineer, and so he said, “I’m thinking this would work even better if I was erect before treatment.” He didn’t say it in a creepy way. I don’t have any creepers. I’ve been fortunate. The ER doctor in me can spot them, so they never make it back in my clinic.
He said, “I can’t use the pump at home, but can I use one here? I think it’ll work better, because sound travels better through fluid than it does through air.” Who was I, going to argue with an engineer? I barely passed physics. I said, “Sure,” I experimented with that, and did the treatment. He experienced some results but wanted more. He said he couldn’t even masturbate. We both felt bad, because it’s sad when your genitals don’t do what your brain wants them to do.
I traveled to Miami for GAINSWave training to become a better sexual wellness doctor in Austin. I took my husband to get trained, because I thought men would be more comfortable with a man doing their treatment, than a woman. In the same way, many women prefer a female OB. I don’t care. Many men prefer a female for their treatment.
My phone was ringing. Many men came to my waiting room for this new treatment, and they were getting results. One person didn’t expect great results. He had Parkinson’s and his wife didn’t know. This is a common thing. Often, the wives of men in their 50s and 60s have wives that often don’t know. He told his wife that he was coming to a Parkinson’s support group.
He would try to touch her and she would be cold. Clearly, there was more going on than just the anatomy not working. He sent me an email thanking me for doing everything that I could to try to help him through medication and through treatments and talking and encouraging him to talk to his wife, and reconnect to her. I couldn’t believe how grateful all these people were.
I’ve received flowers and candy from men who were truly happy that someone listened to them and somebody cared. I take my time with people. I send everyone a handwritten thank you note in the mail with a stamp, signed by their new sexual wellness doctor in Austin. It’s the most rewarding thing for me.
I flashed back to Guatemala and thought, “These people love me, and they love what I’m doing for them. There’s nobody doing and who’s willing helping.” That’s where Austin Love Doctor came from.
I would love to help anybody else that wants me to help them in whatever way that I’m able. Try visiting a sexual wellness doctor in Austin. If I don’t think I can help you, I’ll connect you with the person that can, so listen to my podcast and visit our website at AustinLoveDoctor.com.”
Don’t forget to catch regular podcasts with our sexual wellness doctor in Austin, Dr. Porter!
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